Purpose: The purpose of this exercise was to explore the nurses’ experiences in relation to the seriously ill patient. Good interpersonal relationships are described as being the “core” of the nursing profession and also as a central value in other aspects of healthcare provision. The purpose of investigating this relationship was to bring forth the nurses’ experiences, which can be important in terms of addressing the needs of experienced nurses as well as to prepare nursing students and newly qualified staff for the challenges presented by this type of work.
Literature review: Prior research reveals an ambiguity in the nurses’ experiences in connection with the seriously ill patient; in other words, the most demanding experience can also be the one that gives the most to the carer. The nurses’ capacity for involvement appears to be dependent on experience and maturity and is perceived by the nurses as being central in their relationship with the patient. The nurses’ relationship with the seriously ill patient is tied in with knowledge of self as well as professional and personal development.
Method: This is a qualitative study and the data collected take the form of semi-structured, depth interviews. A theoretical analysis was undertaken with starting point in Schibbye’s “Dialectic-relations-theory”. The terms used were: ”Recognition”, ”self-delimitation”, ”wondering” and ”self-reflection”. The procedure followed was an adaptation of Malterud’s analysis method: ”Systematic text condensing”.
Results: 11 categories emerged in the analysis of the material: “Being with someone and seeing the other - and yourself”, “Acceptance of the other’s experience, but not always of their conclusions and choices”, “protection of the patient”, “reflection meetings”, “reflection as experience and personal process”, “conditions for reflection meetings”, “contrasts and indications”, “intimacy and distance”, “finding limits”, “experience and self-reflection”, “The difficult dialogue between honesty and hope”.
Conclusion: The nurses may be affected, challenged and acknowledged in there relationship work and are understood to move, or balance, on a tightrope between various considerations/needs and/or relational positions where the solution is characterised more by “both-and” than “either-or”:
• The nurse shall both “see” the other (I – you) and at the same time recognise and tolerate it (I – me). • The nurse shall both “be with” the other (I – you) and establish boundaries (I – me). • The nurse is with the patient but at the same time want to be “really” with the patient.• The nurse shall both understand the other (I – you) and at the same time consider the other (I – it).
This work can be perceived as dialectic processes in the relational work with the patient.